Provider Demographics
NPI:1265679526
Name:ARTHUR-BANNING, LISA ALAINE (FNP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ALAINE
Last Name:ARTHUR-BANNING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 MCMILLAN RD BOX 344054
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29634-0001
Mailing Address - Country:US
Mailing Address - Phone:864-656-0692
Mailing Address - Fax:864-656-1619
Practice Address - Street 1:735 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-1497
Practice Address - Country:US
Practice Address - Phone:864-656-0692
Practice Address - Fax:864-656-1619
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR99337363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner